Article 64(8); Aug 2021
Review Articles
Allergy
Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis
Hye Yung Yum, Eun Kyo Ha, Yoon Ho Shin, Man Yong Han
Clin Exp Pediatr. 2021;64(8):373-383.   Published online August 10, 2020
Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%–89% of the chronic rhinitis cases, affecting 1%–50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally...
Neurology
Is it really a seizure? The challenge of paroxysmal nonepileptic events in young infants
Seung Yeon Jung, Joon Won Kang
Clin Exp Pediatr. 2021;64(8):384-392.   Published online September 18, 2020
Paroxysmal nonepileptic events (PNE) comprise of a variety of nonepileptic behaviors and are divided into various types. A more accurate diagnosis is possible by examining the video clip provided by the caregiver. In infants, physiologic PNE accounts for the majority of the PNE. It is important to exclude epilepsy, for which blood tests, electroencephalography, and imaging tests can facilitate differential...
Allergy
Food allergies and food-induced anaphylaxis: role of cofactors
Meeyong shin
Clin Exp Pediatr. 2021;64(8):393-399.   Published online November 12, 2020
Question: What are the roles of cofactors in food allergies and food-induced anaphylaxis?
Finding: Cofactors reportedly play a role in approximately 14%–30% of anaphylactic reactions. Cofactors such as exercise, infection, nonsteroidal anti-inflammatory drugs, dehydration, and alcohol can increase intestinal permeability and antigen uptake, thereby causing allergic symptoms.
Meaning: Routine assessment of the possible involvement of cofactors is essential for the management of patients with food-induced anaphylaxis.
Hematology
Thrombosis and severe acute respiratory syndrome coronavirus 2 vaccines: vaccine-induced immune thrombotic thrombocytopenia
Young Shil Park
Clin Exp Pediatr. 2021;64(8):400-405.   Published online June 30, 2021
· Thrombosis and thrombocytopenia occurring within 4–28 days after severe acute respiratory syndrome coronavirus 2 vaccination require attention.
· The terms vaccine-induced immune thrombotic thrombocytopenia (VITT) and thrombosis with thrombocytopenia syndrome (TTS) are used.
· VITT is pathogenetically similar to heparin-induced thrombocytopenia.
· VITT/TTS could be associated with the development of platelet-activating anti-platelet factor 4 antibodies.
· For suspected VITT/TTS, early treatment decisions (intravenous immunoglobulin, non-heparin anticoagulant, and avoidance of platelet transfusions) are important.
Editorial
Nephrology (Genitourinary)
Pulmonary thromboembolism: a rare but life-threatening complication of nephrotic syndrome
Heeyeon Cho
Clin Exp Pediatr. 2021;64(8):406-407.   Published online February 4, 2021
Pulmonary thromboembolism (PTE) is often diagnosed in children with nephrotic syndrome. Massive PTE can cause hemodynamic instability, right ventricular failure, and circulatory collapse. Extracorporeal membrane oxygenation can be used for massive PTE as a method of hemodynamic support and adjunct to surgical embolectomy.
Original Articles
Allergy
Influence of age at complementary food introduction on the development of asthma and atopic dermatitis in Korean children aged 1–3 years
Jihyun Lee, Meeyong Shin, Bora Lee
Clin Exp Pediatr. 2021;64(8):408-414.   Published online November 1, 2020
Question: Is age at the time of complementary food introduction associated with asthma and atopic dermatitis (AD) in early childhood?
Finding: We found no significant association between age at the time of complementary food introduction and the incidence of AD and asthma in Koreans aged 1–3 years.
Meaning: Our findings suggest that the influence of individual allergenic foods on the development of AD and asthma should be clarified.
Infection
Prevalence of methicillin-resistant Staphylococcus aureus in Iranian children: a systematic review and meta-analysis
Farhad Sarrafzadeh, Seyed Mojtaba Sohrevardi, Hamid Abousaidi, Hossein Mirzaei
Clin Exp Pediatr. 2021;64(8):415-421.   Published online November 20, 2020
The pooled prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 42% among culture-positive cases of S. aureus, 51% in hospitalized children, and 14% in healthy children. The high prevalence of MRSA in Iranian children may be due to insufficient infection control measures in hospitals, inappropriate use of methicillin, inadequate staff training, and over-prescription of antibiotics in Iran.
Neonatology (Perinatology)
Effects of carnosine and hypothermia combination therapy on hypoxic-ischemic brain injury in neonatal rats
Jun Chul Byun, Seong Ryong Lee, Chun Soo Kim
Clin Exp Pediatr. 2021;64(8):422-428.   Published online February 24, 2021
Question: How can we further improve the neuroprotective effects of hypothermia in newborns with hypoxic-ischemic (HI) brain injury?
Finding: Combination carnosine and hypothermia therapy effectively reduced brain damage in neonatal rats. The in situ zymography, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, and immunofluorescence study results showed that neuroprotective effects were achieved with combination therapy only.
Meaning: Carnosine and hypothermia have synergistic neuroprotective effects against brain damage following HI injury
Clinical note
Nephrology (Genitourinary)
Extracorporeal membrane oxygenation with systemic heparinization as a rescue therapy for acute life-threatening pulmonary thromboembolism complicating nephrotic syndrome
Kyusang You, So Mi Kim, Dongmin Kim, Kyoungmin Ryu, Mee Jeong Lee
Clin Exp Pediatr. 2021;64(8):430-432.   Published online November 16, 2020
Question: How would you treat acute life-threatening pulmonary thromboembolism occurring in nephrotic patients?
Finding: A 16-year-old woman with minimal change-associated nephrotic syndrome presented with cardiac arrest caused by an acute bilateral pulmonary thromboembolism. Her hemodynamics stabilized with resolution of thrombi while on venoarterial extracorporeal membrane oxygenation (ECMO) and systemic heparinization.
Meaning: In selected cases, ECMO with systemic heparinization may rescue patients from acute life-threatening pulmonary thromboembolism even without reperfusion therapy.
Letter to the Editor
General Pediatrics
Skipping breakfast is associated with lifestyle habits among Japanese pupils
Jun Kohyama
Clin Exp Pediatr. 2021;64(8):433-435.   Published online November 4, 2020
Question: Breakfast is important; however, adolescents are increasingly skipping it.
Finding: Skipping breakfast is independently associated with sleepiness, physical inactivity, dinner irregularity, screen time on school days, poor academic performance, after-school activity, and decreased sleep duration before school day.
Meaning: Reducing screen time on school days, after-school activity, and irregular dinner habits might decrease breakfast skipping, resulting in decreased sleepiness and improved academic performance.
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